Provider Demographics
NPI:1922446459
Name:FERNANDEZ, ROBERTO JOAQUIN (DO MPH)
Entity Type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:JOAQUIN
Last Name:FERNANDEZ
Suffix:
Gender:M
Credentials:DO MPH
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Mailing Address - Street 1:1001 E SUPERIOR ST STE L101
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-2207
Mailing Address - Country:US
Mailing Address - Phone:218-249-3081
Mailing Address - Fax:218-249-7875
Practice Address - Street 1:1001 E SUPERIOR ST STE L101
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802
Practice Address - Country:US
Practice Address - Phone:218-249-3081
Practice Address - Fax:218-249-7875
Is Sole Proprietor?:No
Enumeration Date:2013-06-06
Last Update Date:2020-12-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN66358207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5101020232OtherLICENSE